title: Problem alcohol use among problem drug users: development and content of clinical guidelines for general practice.
abstract: BACKGROUND
  Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment.
  
  
  OBJECTIVE
  This paper aims to describe the development and content of clinical guidelines for the management of problem alcohol use among this population.
  
  
  METHODS
  The guidelines were developed in three stages: (1) identification of key stakeholders, (2) development of evidence-based draft guidelines, and (3) determination of a modified 'Delphi-facilitated' consensus among the group members.
  
  
  RESULTS
  The guidelines incorporate advice for physicians on all aspects of care, including (1) definition of problem alcohol use among problem drug users, (2) alcohol screening, (3) brief intervention, and (4) subsequent management of patients with alcohol dependence.
  
  
  CONCLUSIONS
  Primary care has an important role to play in the care of problem alcohol use among problem drug users, especially opiate substitution patients. Further research on strategies to inform the implementation of these guidelines is a priority.
authors.affiliation: Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland, jan.klimas@ucd.ie.
authors.forename: J
authors.initials: J
authors.lastname: Klimas
authors.forename: W
authors.initials: W
authors.lastname: Cullen
authors.forename: C-A
authors.initials: CA
authors.lastname: Field
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D032921:Consensus; D003697:Delphi Technique; D055030:Drug Users; D019317:Evidence-Based Medicine; D058006:General Practice / Q000592:standards*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011613:Psychotherapy / Q000592:standards; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*